Effects of inspiratory muscle training on inspiratory muscle strength and exercise tolerance in patients with COPD: a meta-analysis and systematic review

作者：Lei Xu, Qi Liao · 发表于：Frontiers in Medicine · 年份：2026 · DOI：10.3389/fmed.2026.1855676 · 研究领域：Chronic Obstructive Pulmonary Disease (COPD) Research、Cardiovascular and exercise physiology、Respiratory Support and Mechanisms

Objective To systematically evaluate the effects of inspiratory muscle training (IMT) on inspiratory muscle strength, exercise tolerance, and dyspnea in patients with COPD, including both stable and post-AECOPD rehabilitation-phase participants, and to explore the moderating role of comparator type on treatment efficacy. Methods Following PRISMA 2020 guidelines, we systematically searched PubMed, Embase, Cochrane Library, Web of Science, and Scopus from inception to March 1, 2026. Randomized controlled trials (RCTs) involving adults with stable COPD were included. The primary outcomes were PImax, 6MWD, and dyspnea (SMD). A random-effects model was used to pool effect sizes, and subgroup analyses, sensitivity analyses, and meta-regression were performed. Results Thirteen RCTs ( n = 1,170) were included. IMT significantly improved PImax (SMD = 1.23, 95%CI 0.12–2.34, p = 0.034, I 2 = 90.9%) and 6MWD (SMD = 0.43, 95%CI 0.09–0.77, p = 0.018, I 2 = 70.6%). The improvement in 6MWD reached statistical significance only in the sham-controlled subgroup (SMD = 0.51, p = 0.046), whereas no additional benefit was observed in the “IMT added to pulmonary rehabilitation (PR)” subgroup (SMD = −0.05, p = 0.875). Dyspnea showed a favorable trend that did not reach statistical significance (SMD = 0.33, 95%CI −0.11–0.77, p = 0.129), and no significant improvement was found in FEV₁ (MD = 0.14 L, 95%CI −0.17–0.44, p = 0.190). Meta-regression suggested that comparator type explained approximately 37...